Organization
ORTHO 99 PLUS 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN E. MCDANIEL DMD (DMD-OWNER)
(850) 559-0555
Entity
Organization
Contact information
Practice address
7410 MERRILL ROAD, SUITE 2, JACKSONVILLE, FL 32277
(904) 619-7140
Mailing address
7410 MERRILL ROAD, SUITE 2, JACKSONVILLE, FL 32277
(904) 619-7140
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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